Litigation


RI Health System Paid $1 Million HIPAA Settlement
July 28, 2020 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Litigation
After a long quiet period, the second HIPAA settlement to be announced by the U.S. Department of Health and Human Services (HHS) in an orchestrated one-two punch was far more costly to the second violator. Lifespan Health System Affiliated Covered Entity paid $1,040,000 to HHS’s Office for Civil Rights (OCR) in June for failing to …
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NC Health Center Pays HIPAA Settlement
July 27, 2020 | Eric D. Fader | Electronic Health Records | HIPAA | Litigation
The U.S. Department of Health and Human Services (HHS) announced on July 23 that Metropolitan Community Health Services (Metro) paid $25,000 to HHS’s Office for Civil Rights (OCR) to resolve HIPAA violations. Metro, a Federally Qualified Health Center, operates two multidisciplinary medical clinics in eastern North Carolina under the name of Agape Health Services. Metro …
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HHS, DOJ Release Fraud and Abuse Report
July 23, 2020 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Home Health | Hospitals | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Telehealth
The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion, of which about $2.5 billion was returned to the Medicare trust fund. The recoveries included judgments and settlements from fraud …
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Rivkin Health Attorneys Write the Book on Federal AKS and Safe Harbors
July 10, 2020 | Rivkin Rounds Staff | Electronic Health Records | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Pharmaceuticals | Private Insurers
Eric Fader, Jeff Kaiser, Chris Kutner, Ada Kozicz and Ben Malerba are authors of the newly released book, “The Federal Anti-Kickback Statute and Safe Harbors: A Practical Guide.” Published by the American Bar Association, the book covers all safe harbors currently in place, as well as the interplay between the Anti-Kickback Statute (AKS) and other …
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VNSNY Agrees to $57 Million Settlement
June 29, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY, …
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Hospital Price Transparency Rule Upheld
June 24, 2020 | Eric D. Fader | Affordable Care Act | Hospitals | Legislation and Public Policy | Litigation | Private Insurers
On June 23, the U.S. District Court for the District of Columbia ruled against the American Hospital Association and other associations and individual hospitals that had sued the U.S. Department of Health and Human Services (HHS) to block a new price transparency rule that will take effect on January 1, 2021. The rule, which was finalized …
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Assess Legal Risk, Payer Policies to Head Off Hidden Dangers of COVID-19 Reopening
May 21, 2020 | Rivkin Rounds Staff | Legislation and Public Policy | Litigation | Private Insurers
A May 18 article in Part B News, “Assess legal risk, payer policies to head off hidden dangers of COVID-19 reopening,” discussed how medical practices should take steps to protect themselves from legal and insurance issues. Rivkin Radler’s Robert Iseman was quoted in the article, which advises medical practices that are beginning to reopen on …
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False Claims Act, Medical Necessity and Government Regulation of Medicine
May 14, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here. …
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Supreme Court Rules in Favor of Health Insurers Under ACA Program
April 29, 2020 | Mark J. Wagner Jr. | Affordable Care Act | Litigation | Private Insurers
On April 27, the U.S. Supreme Court ruled in favor of commercial health insurers that were seeking $12 billion under the Affordable Care Act’s risk corridor program, acknowledging that the ACA “obligated the government to pay the full amount of risk corridor payments.” The ACA established the risk corridor program to mitigate the risks assumed …
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OCR Pushes Back Against Discriminatory State Triaging Guidelines
April 22, 2020 | Carol A. Hyde | Cassandra Rivais DiNova | Hospitals | Legislation and Public Policy | Litigation
Two recent decisions of the Department of Health and Human Services Office for Civil Rights (OCR) illustrate that age and disability status cannot be used as blanket criteria for denying access to health care services, even during a pandemic. This should serve as a warning to healthcare providers about the risks in making triage decisions …
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